A Unique Cause of a Rare Disorder, Unilateral Macromastia Due to Lymphangiomatosis of the Breast: A Case Report

Abstract

Macromastia and in particular unilateral macromastia is a rare clinical entity. It relates to massive enlargement of the breast in non-obese women. This case report describes an initially mild unilateral asymmetry occurring nine months postpartum in a 33-year-old female. However, following her second pregnancy within 12 months, her left breast became severely enlarged. This did not improve on delivery. No discrete lesion was seen on imaging and no significant abnormalities were seen in her blood chemistry. Surgical treatment was a mammoplasty and 580 g of mammary tissue was removed. Grossly, there was spongiform subcutaneous tissue with diffuse extension. On histology, this consisted of a highly complex and diffuse pattern of infiltration and of cavernous empty channels lined by a delicate attenuated endothelium which was CD34 and D2-40 positive. The appearances were consistent with lymphangiomatosis, more commonly encountered in the limbs, heretofore. Lymphangiomatosis has not been previously described in breast tissue and only a single case report exists for such a lesion in axillary tissue. Treatment of such lesions in the periphery by surgical excision is very difficult and excision without being radical can be impossible. Follow up of our patient, shows no evidence of recurrence in this patient. Our case report describes the clinicopathological features, differential diagnosis to be considered and treatment, in addition to reviewing the relevant literature.

An Exceptional Case of Gestational Gigantomastia

“…The association of gestational gigantomastia with bilateral breast lumps is truly exceptional. Rare cases of gigantomastia associated with breast lumps have been reported, but only under circumstance of unilateral gigantomastia [25][26][27]. This case report describes a case of bilateral gestational gigantomastia with bilateral breast lumps.…”

Retroperitoneal lymphangioma in a pregnant patient: A case report and literature review

“…The search identified 15 articles concerning pregnant women with lymphangiomas [ [1] , [2] , [3] , [4] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , [15] , [16] ]. Five articles were excluded from the analysis: four due to postpartum diagnosis [ 3 , [6] , [7] , [8] ] and one due to pregestational diagnosis [ 9 ].…”

Imaging and Clinical Features of an Unusual Unilateral Breast Enlargement Diagnosed as Fibrocystic Change: A Case Report

“…Various conditions can cause unilateral breast enlargement, including those of both benign and malignant tumorous etiology or non-tumorous etiology. Benign conditions include breast edema of benign etiology (intramammary such as mastitis, fat necrosis, trauma, post-irradiation changes, or granulomatous disease; extramammary such as lymphatic obstruction, nephrotic syndrome, progressive systemic sclerosis, pemphigus and other skin conditions, subclavian or innominate vein occlusion, or congestive heart failure) [13], pubertal macromastia (juvenile or virginal hypertrophy) [14–16], gravid macromastia [17], breast hypertrophy secondary to endocrine disorders (hypothalamic lesions, polyostotic fibrous dysplasia, ovarian granulosa cell tumor, follicular cyst, or adrenocortical tumors) [16], lymphangiomatosis [18], pseudoangiomatous stromal hyperplasia [19–21], giant fibroadenoma of adult or juvenile type [22], giant phyllodes tumor [23], giant lipoma [24,25], and giant hamartoma [26]. Malignant conditions include edema of malignant etiology (intramammary such as inflammatory breast carcinoma; extramammary such as lymphoma or leukemia) [13], giant malignant phyllodes tumor [27], and various types of carcinoma such as medullary, mucinous, and lymphoma [28].…”